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Journal of the National Medical Association logoLink to Journal of the National Medical Association
. 2005 Dec;97(12):1725–1728.

Trimethoprim-sulfamethoxazole-induced aseptic meningitis.

Charles Wambulwa 1, Salome Bwayo 1, Adeyinka O Laiyemo 1, Fredric Lombardo 1
PMCID: PMC2640752  PMID: 16396068

Abstract

We present a 46-year-old African-American man with AIDS who was admitted on two different occasions within three weeks for signs and symptoms of meningitis after using trimethoprim/sulfamethoxazole (TMP/SMX). TMP/SMX is primarily used for the treatment of pneumocystis carinii pneumonia prophylaxis in AIDS patients. Drug-induced aseptic meningitis (DIAM) is commonly seen with nonsteroidal anti-inflammatory drugs (NSAIDS), antibiotics (with TMP/SMX being the most frequently implicated), intravenous immunoglobulins and OKT3 antibodies. However, the implication of TMP/SMX inducing aseptic meningitis has been underreported to FDA/MEDWATCH program. This might be due to the fact that it has also been used to treat bacterial meningitis from organisms like Listeria monocytogenes, which is a common pathogen in the elderly and in infants. We reviewed the literature in an attempt to characterize the pattern and predictors of TMP/SMX-induced aseptic meningitis.

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Selected References

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